Efficiency of Different Endodontic Irrigation and Activation Systems, Self-Adjusting File Instrumentation/Irrigation System, and XP-Endo Finisher in Removal of the Intracanal Smear Layer: An Ex vivo Scanning Electron Microscope Study.

AIM: This ex vivo study was designed to evaluate and compare different endodontic irrigation and activation systems, the self-adjusting file (SAF) instrumentation/irrigation system, and XP-endo finisher for removal of intracanal smear layer. MATERIALS AND METHODS: Fifty recently extracted, noncarious human intact single-rooted premolars were selected and divided into five groups (n = 10) according to the root canal irrigation systems; syringe and needle irrigation, passive ultrasonic irrigation (PUI), EndoVac irrigation system, SAF system, and XP-endo finisher. All groups were prepared to apical size F4 file except for the SAF group which was prepared to apical size 20 K-file and then instrumented with the SAF file. Each sample was subjected to final irrigation using different irrigation/activation systems. After splitting the samples, one half of each root was selected for examination under scanning electron microscope. The irrigation systems were compared using the Fisher's exact test with significance set at P < 0.05. RESULTS: In the coronal part, there was no difference among the groups. In the mid-root section, the results of the PUI, EndoVac, SAF, and XP-endo finisher groups tended to be better than syringe and needle irrigation, but the difference was not significant. The apical part of the canal, the SAF system, and XP-endo finisher group seemed to be cleaner than those of the EndoVac group, but this difference was not significant. CONCLUSIONS: Within the limitations of the present study, SAF system and XP-endo finisher group cleaned the apical part of the canal more efficiently than EndoVac, PUI, and syringe and needle irrigation.

Assessment of Age-Related Changes of Salivary Immunoglobulin A Levels among Healthy Individuals.

BACKGROUND: Secretory immunoglobulin A (IgA) is the first line of defense against pathogens that invade mucosal surfaces. It has been reported that the immune system exhibits profound age-related changes. The aim of this study was to investigate the age-dependent changes of salivary IgA among healthy individuals. MATERIALS AND METHODS: Saliva samples were collected from 120 healthy individuals (aged 11-70 years). The salivary IgA concentrations were measured by the use of a single radial immunodiffusion technique and analyzed using the Mann-Whitney U, Kruskal-Wallis, and Chi-square tests. RESULTS: The mean salivary IgA levels were 81.11 ± 4.50 mg/dl at age 11-20 years, 92.71 ± 13.76 mg/dl at age 21-30 years, 96.50 ± 4.04 mg/dl at age 31-40 years, 104.96 ± 10.15 mg/dl at age 41-50 years, 113.22 ± 7.85 mg/dl at age 51-60 years, and 91.38 ± 4.77 mg/dl at age 61-70 years. There was a significant difference among the mean salivary IgA levels of different age groups (P < 0.001). CONCLUSION: These results showed that the salivary IgA levels exhibit age-related changes. Oral immunization may be considered to improve oral immunity when the salivary concentrations of IgA begin to decrease during lifetime.

CBCT Evaluation of Gutta-Percha Removal Using Protaper and Mtwo Retreatment Files, Wave One, and Hedstrom Files: An Ex Vivo Study.

Objectives: This study aimed to evaluate the efficacy of ProTaper, Mtwo, and WaveOne retreatment files and Hedstrom files for removal of gutta-percha from the straight root canals using cone-beam computed tomography (CBCT). Materials and Methods: Forty freshly extracted single-rooted and single-canal teeth were selected for this study. The teeth were decoronated, and biomechanical preparation was performed up to #30 K-file. The root canals were obturated using lateral compaction technique with gutta-percha and Resilon sealer. The teeth were then randomly divided into 4 groups, and CBCT images were obtained. All the canals were then retreated with either ProTaper retreatment files, Mtwo retreatment files, WaveOne files, or Hedstrom files. The surface area of the remaining filling material after the retreatment procedure was quantified by CBCT. Statistical analysis was performed via one-way ANOVA and the Tukey-Kramer multiple comparisons test. Results: None of the file systems could completely remove the filling material from the canals. Data analysis revealed significant differences between the groups in the apical and middle thirds (P<0.05). Conclusion: All the file systems left some filling material in the canals. Mtwo retreatment files had maximum efficacy for removal of filling materials in comparison with other files. WaveOne files can also be used for root canal retreatment.

Smear Layer Removal Efficacy Using EndoActivator and EndoUltra Activation Systems: An Ex Vivo SEM Analysis.

OBJECTIVE: This study evaluated intracanal smear layer removal using syringe and needle irrigation (ie, conventional irrigation [CI]) with and without adjunctive activation using EndoActivator® or EndoUltra®. MATERIALS AND METHODS: Thirty-five premolars were divided into three experimental groups (n = 10) and a control (n = 5): (1) CI, (2) CI plus sonic activation (EndoActivator), (3) CI plus ultrasonic activation (EndoUltra), or (4) CI using saline. All teeth were prepared to a size #40 K file. Following irrigation, the teeth were split and imaged using scanning electron microscopy (SEM). SEM images were evaluated by: (1) blinded researchers who provided a smear layer score (1-5), and (2) a custom software algorithm that automatically and independently quantified the number of open tubules. RESULTS: Use of both the EndoActivator and EndoUltra resulted in significantly cleaner smear layer scores at all canal thirds compared to CI (P < .001). The EndoUltra yielded significantly cleaner scores than the EndoActivator at the apical third (P < .001); however, no significant difference was evident in the middle and coronal thirds. The software analysis yielded the same conclusions as the smear layer scores except statistical significance was seen between the EndoUltra and EndoActivator at all canal thirds (P < .02). Of the adjunctive irrigant activators, the EndoUltra opened 94%, 117%, and 26% more tubules in the apex, middle, and coronal thirds, respectively, than the EndoActivator. CONCLUSIONS: The EndoUltra cleaned canals more effectively than the EndoActivator and CI.

Efficiency of Different Endodontic Irrigation and Activation Systems in Removal of the Smear Layer: A Scanning Electron Microscopy Study.

INTRODUCTION: This in vitro study was designed to evaluate and compare different endodontic irrigation and activation systems for removal of the intracanal smear layer. METHODS AND MATERIALS: Forty recently extracted, non-carious human intact single rooted premolars were selected and divided into five groups (n=10) according to the root canal irrigation systems; syringe and needle irrigation (CTR), sonic irrigation, passive ultrasonic irrigation (PUI) and EndoVac irrigation system. All groups were prepared to #40 apical size with K-files. Each sample was subjected to final irrigation by using four different irrigation/activation systems. After splitting the samples, one half of each root was selected for examination under scanning electron microscope (SEM). The irrigation systems were compared using the Fisher's exact test with the level of significance set at 0.05. RESULTS: The four groups did not differ from each other in the coronal and mid-root parts of the canal. In the apical part of the canal none of the methods could completely remove all the smear layer but EndoVac system showed significantly better removal of smear layer and debris than the other methods. CONCLUSION: Within the limitations of the present study, the EndoVac system cleaned the apical part of the canal more efficiently than sonic, ultrasonic and syringe and needle irrigation.

Grape seed extract: An innovation in remineralization.

AIM: The aim of this study was to determine remineralizing potential of grape seed extract (GSE) compared to casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and calcium glycerophosphate (CaGP) through pH-cycling model and subsequent evaluation using polarized light microscope (PLM). SUBJECTS AND METHODS: Twenty sound human teeth fragments of ten teeth were obtained from the cervical portion of the roots and were stored in demineralizing solution for 96 h at 37°C to induce artificial root carious lesion. The sections then were divided into four treatment groups including: 6.5% GSE, CPP-ACP, 0.5% CaGP, and control group (no treatment). The demineralized samples were then pH cycled through treatment solutions, acidic buffer, and neutral buffer for 8 days at six cycles per day. The samples were subsequently evaluated using PLM. STATISTICAL ANALYSIS USED: Data were analyzed using ANOVA and Scheffe post hoc comparison test (P < 0.001). RESULTS: PLM data revealed a significantly thicker mineral precipitation band on the surface layer of the GSE-treated lesions compared to the other groups (P < 0.001). CONCLUSION: GSE positively affects the demineralization and/or remineralization processes of artificial root caries lesions.

Bilateral Three Rooted Mandibular Premolars and Four Rooted Mandibular First and Second Molar: A Rare Anatomical Variant.

The mandibular premolars and molars exhibit wide variations in the form of roots and root canals. A bilateral symmetry of three rooted mandibular first and second premolar and four rooted mandibular first and second molar in a same patient is a rare entity and one such case is presented in this case report.